Activity-dependent plasticity and spinal cord stimulation for motor recovery following spinal cord injury

Spinal cord injuries lead to permanent physical impairment despite most often being anatomically incomplete disruptions of the spinal cord. Remaining connections between the brain and spinal cord create the potential for inducing neural plasticity to improve sensorimotor function, even many years after injury. This narrative review provides an overview of the current evidence for spontaneous motor recovery, activity-dependent plasticity, and interventions for restoring motor control to residual brain and spinal cord networks via spinal cord stimulation. In addition to open-loop spinal cord stimulation to promote long-term neuroplasticity, we also review a more targeted approach: closed-loop stimulation. Lastly, we review mechanisms of spinal cord neuromodulation to promote sensorimotor recovery, with the goal of advancing the field of rehabilitation for physical impairments following spinal cord injury.

Automated summary

Spinal cord injuries often result in permanent physical impairments despite being incomplete disruptions. However, remaining connections between the brain and spinal cord can induce neural plasticity to improve sensorimotor function, even years post-injury. This review provides an overview of evidence for motor recovery, plasticity, and interventions in spinal cord stimulation for motor control restoration. It discusses both open-loop and closed-loop stimulation approaches, as well as mechanisms of spinal cord neuromodulation for sensorimotor recovery, aiming to advance rehabilitation for spinal cord injuries.